People with fibromyalgia (fI-bro-my-AL-gee-ah) syndrome, or FMS,
live with constant pain in their muscles and soft tissues. Because the
pain is spread throughout the body and because a variety of other symptoms
can accompany the disease, fibromyalgia syndrome is often difficult to
diagnose.

According to the 2003 National Ambulatory Medical Care Survey from
the Centers for Disease Control and Prevention, approximately 4.9 million
people in the United States have fibromyalgia syndrome. Women between 20
and 60 years of age are most at risk. The cause of fibromyalgia syndrome
is unknown, but factors that may contribute to its development include
sleep disturbances, psychological stress, changes in muscle metabolism,
and abnormalities in a person's immune, endocrine, or nervous systems.
The symptoms of fibromyalgia are slightly different in every person.

Symptoms

Pain is the most compelling symptom of fibromyalgia syndrome. The
pain may be aching, burning, throbbing, shooting, or a stabbing pain. It
often hurts worse in the morning. The pain may be constant and chronic.
The pain may be focused in
"
trigger points
"
on the body.

It can be difficult to diagnose fibromyalgia syndrome because no
test can prove its presence. Neither X-rays nor lab tests show any abnormalities.
These tests can be used to rule out other conditions with similar symptoms.
The patient's medical history and description of the symptoms are useful
in the diagnosis. The following criteria have been established for a diagnosis
of fibromyalgia syndrome:

Widespread pain for at least 3 months:

Pain on both right and left sides of the body

Pain both above and below the waist

Pain in the skeletal spine and/or chest

Pain and tenderness at 11 or more of 18 trigger points, when pressed
with a finger with an approximate force of 8.8 pounds.

There are nine paired sets of trigger points, located at the same
spot on both the left and right sides of the body.

Trigger points are located at the base of the skull, in the neck,
shoulders, chest and lower spine, buttocks, hips, elbows, and knees.

Treating fibromyalgia syndrome is a team approach that involves the
physician, the patient, and possibly several other health care professionals.

There is no definitive treatment that will cure fibromyalgia syndrome.
Treatment is an ongoing process that can involve several different modalities
to help control pain and improve function. Fibromyalgia syndrome is not
a life-threatening or progressive disease, but a chronic condition that
can be managed successfully in many cases. Treatment plans must be individualized
to respond to the patient's needs and lifestyle.

Certain medications, including antidepressants and pain relievers,
can be helpful. A gradual exercise program designed to increase flexibility,
build endurance, and enhance cardiac fitness is also important. Additional
therapies may involve heat or cold applications, massage, weight control,
psychological counseling, and participation in support groups.

AAOS does not endorse any treatments, procedures, products, or physicians referenced
herein. This information is provided as an educational service and is not intended
to serve as medical advice. Anyone seeking specific orthopaedic advice or assistance
should consult his or her orthopaedic surgeon, or locate one in your area through
the AAOS "Find an Orthopaedist" program on this website.